NPIMap

Organization Active NPI

Elite Therapy Institute LLC

Doing business as ET I Wound Healing Center

  • Physical Therapy Clinic/Center
  • Rice Lake, WI
National Provider Identifier
1760576789
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ELITE THERAPY INSTITUTE LLC
Doing business as
ET I Wound Healing Center
Practice address
1801 W Knapp St
Suite 4
Rice Lake, WI 54868
Phone
(715) 736-4384
Fax
(844) 829-7001
NPI assigned
Oct 3, 2006
Last updated
Dec 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Gregory L Eck, PTNPI 1487627576
Title
Owner
Phone
(715) 736-4384

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1801 W Knapp St
Suite 4
Rice Lake, WI 54868

Mailing address

1801 W Knapp St
Suite 4
Rice Lake, WI 54868
Phone (715) 736-4384

Other names 2

  • ET I Wound Healing Center Doing business as
  • Elite Therapy Institute Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061019000548 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0941206676 Receives reassigned benefits from 3 practitioners
Practice locations: Eau Claire, WI; Rice Lake, WI

National Provider Directory

National Provider Directory

Locations

916 Carmichael Rd
Hudson, WI 54016
Phone (715) 505-3030

1801 W Knapp St
Ste 4
Rice Lake, WI 54868
Phone (715) 736-4384

2021 Cenex Dr
Unit E
Rice Lake, WI 54868
Phone (715) 234-9876

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18208/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1760576789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W KNAPP ST",
            "address_2": "SUITE 4",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "54868",
            "telephone_number": "715-736-4384",
            "fax_number": "844-829-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W KNAPP ST",
            "address_2": "SUITE 4",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "54868",
            "telephone_number": "715-736-4384",
            "fax_number": "844-829-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE THERAPY INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "ECK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-736-4384",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ET I Wound Healing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elite Therapy Institute",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.